Louisiana H1N1 Tamiflu Resistance Expands To Utah

Wednesday, December 4, 2013
By Paul Martin

Recombinomics.com
December 3, 2013

The CDC released another series of recent H1N1pdm09 sequences, which included the third Louisiana sequence, A/Louisiana/10/2013, with H274Y. Like the first two cases, A/Louisiana/07/2013 and A/Louisiana/08/2013, all eight gene segments were sequenced and the match signaled clonal expansion. The CDC also released full sequences from two additional Louisiana patients, A/Louisiana/11/2013 and A/Louisiana/12/2013, which were Tamiflu sensitive, but were closely related to all 8 gene segments of the three resistant cases, raising concerns that the sensitive samples included a subset that included H274Y.

Those concerns were increased by a fourth sequence with H274Y, which was from a Utah patient (14F, A/Utah/10/2013). That sequence gave a mixed signal for position 274, but was also closely related to all 8 gene segments in the above Louisiana sequences, suggesting that H274Y was far more widespread than indicated by the four sequences with H274Y.

This concern was increased by the latest FluView (week 47), which cited two more H1N1pdm09 cases that were Tamiflu resistance. The spread of this clone to Utah, and the announcement of two more cases in the week 47 report, raise concerns that the number of cases will continue to increase for the current season, where the vast majority of flu cases are influenza A, and the vast majority of influenza A cases are H1N1pdm09.

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